PROJECT SUMMARY The Wisconsin NCORP (WiNCORP) is a consortium of three established healthcare systems in the state of Wisconsin with a long-standing history of excellence in oncology care ? Marshfield Clinic Health System, Gundersen Health System, and ThedaCare. Through a network of hospitals, clinics, and other facilities spanning most of the state of Wisconsin, upper Michigan and adjacent counties in Northern Iowa and Southeastern Minnesota, WiNCORP institutions collectively provide care and access to oncology clinical trials to a predominantly rural population. Member sites participate in numerous NCI-sponsored clinical trials and are active in NCORP research base committees, NCI task forces and steering committees, research networks, and organizations with a focus on improving cancer care. Investigators from each system are consistently recognized by the NCI and/or the research bases for their accrual totals, and WiNCORP has been designated as a high-performing site over the previous grant cycle. Through the work of multidisciplinary care teams and research staff, WiNCORP will continue to leverage its collective expertise to open numerous cancer care delivery research (CCDR) trials. With a shared mission to provide patient access to NCI-sponsored clinical trials, WiNCORP members are well-positioned to increase patient accruals from historically underrepresented populations in clinical trials such as rural, elderly, and low-income individuals, enhance cancer care delivery, and reduce disparities in cancer burden across the region. To achieve this goal, WiNCORP leadership has outlined four specific aims for the consortium: 1) Conduct NCI Phase I/II, II and III cancer screening, prevention, symptom management, treatment, post-treatment, imaging and quality of life trials across the entire WiNCORP service area. 2) Facilitate conduct of Cancer Care Delivery Research (CCDR) across our integrated health care systems through establishment of an expanded research infrastructure. 3) Facilitate accrual to molecular target driven trials. 4) Incorporate a new patient population and provider group in the WiNCORP consortium that currently has no access to CCDR studies. These specific aims will be accomplished by expanding communication channels between patients and WiNCORP members, streamlining the process of site opening for various clinical trials, enhancing resource sharing among member sites, enhancing community engagement in clinical trial participation, and continual enhancements and developments in infrastructure and personnel to open and accrue patients to a variety of clinical trial types. It is anticipated that WiNCORP-wide efforts in staff education, clinical trial feasibility assessment, harmonized internal processes, synchronized regulatory support, development of system and trial-specific standard operating procedures, and collaboration among investigators from the three consortium sites will create a synergy that will further enhance clinical trial conduct, efficiency, and quality.